肢体远程与局部缺血预处理对大鼠背阔肌肌皮瓣缺血再灌注损伤影响的比较

发布时间：2018-04-18 16:10

本文选题：缺血再灌注损伤 + 缺血预处理　；参考：《山东医药》2017年26期

【摘要】：目的比较局部缺血预处理和肢体远程缺血预处理对大鼠背阔肌肌皮瓣缺血再灌注损伤的影响。方法将40只大鼠随机分为对照组、缺血组、局部缺血预处理组、肢体缺血预处理组各10只。对照组接受假手术,缺血组夹闭胸背动脉3 h后恢复血流灌注1 h,局部缺血预处理组夹闭肌皮瓣胸背动脉进行预处理,肢体缺血预处理组夹闭右股动脉进行预处理。采用缺血10 min后恢复血流灌注10 min进行预处理,预处理结束30 min后再重复缺血组操作。检测缺血前(T_0)、缺血3 h(T_1)、再灌注1 h(T_2)后各组血清一氧化氮(NO)、内皮素(ET)水平,术后第5天光镜下观察背阔肌皮瓣的组织形态学变化。结果与缺血组比较,局部缺血预处理组和肢体缺血预处理组在T_1和T_2时间点血清NO水平升高、ET水平降低(P均0.05),局部缺血预处理组和肢体缺血预处理组比较差异无统计学意义(P均0.05)。与缺血组比较,局部缺血预处理组和肢体缺血预处理组术后第5天肌皮瓣组织病理学损伤减轻,局部缺血预处理组和肢体缺血预处理组的病理学变化比较无明显差异。结论局部缺血预处理和肢体远程缺血预处理均能减轻大鼠肌皮瓣的缺血再灌注损伤,对肌皮瓣具有保护作用。
[Abstract]:Objective to compare the effects of local ischemic preconditioning and remote ischemic preconditioning on ischemia-reperfusion injury of latissimus dorsi myocutaneous flap in rats.Methods 40 rats were randomly divided into control group, ischemic group, local ischemic preconditioning group and limb ischemic preconditioning group.In the control group, the thoracic dorsal artery was clamped for 3 hours and the blood flow was restored for 1 hour. In the local ischemic preconditioning group, the pectoralis dorsalis artery of the musculocutaneous flap was pretreated, and the right femoral artery was clipped in the limb ischemic preconditioning group.After ischemia for 10 min, the blood flow perfusion was pretreated for 10 min. After 30 min preconditioning, the operation was repeated in the ischemic group.The levels of serum nitric oxide (no) and endothelin (et) were measured after T _ 0, T _ 1, T _ 1 and T _ 2 after ischemia. The histomorphologic changes of latissimus dorsi flap were observed under light microscope on the 5th day after operation.Results compared with ischemic group,The level of serum no was increased at the time points of T _ 1 and T _ 2 in the local ischemic preconditioning group and the limb ischemic preconditioning group. The level of et decreased by 0.05%, but there was no significant difference between the local ischemic preconditioning group and the limb ischemic preconditioning group (P 0.05).Compared with the ischemic group, the histopathological damage of the myocutaneous flap was alleviated on the 5th day after operation in the ischemic preconditioning group and the limb ischemic preconditioning group, but there was no significant difference between the local ischemic preconditioning group and the limb ischemic preconditioning group.Conclusion both local ischemic preconditioning and limb remote ischemic preconditioning can reduce the ischemia-reperfusion injury of rat myocutaneous flap and have protective effect on the myocutaneous flap.
【作者单位】：广西医科大学附属口腔医院;
【基金】：广西医疗卫生适宜技术研究与开发项目(S201411-02)
【分类号】：R622

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